There are currently few standards around how the health management industry discusses and measures effectiveness. However, this is about to change. HealthFitness’ Ed Framer, Ph.D., director of health and behavioral sciences, is the co-leader of a collaborative project between the Care Continuum Alliance and the Health Enhancement Research Organization to develop standard metrics for employee health. At the World Congress Wellness & Prevention 3.0 Conference, May 8-9, 2013, he presented an update on the project and project scope.

1. Developing a Core Set
of Metrics for Employee
Health Management

2. Background
• Employer members asked HERO to initiate
work to create a core set of metrics that all
suppliers would measure
• In February, 2011, HERO and Care Continuum
Alliance met to outline a collaborative approach
to address this need
• Our belief is this is a requirement as the health
management industry matures
• Our hope is to include all non-profit
organizations in supporting these recommended
metrics

3.  The Health Enhancement
Research Organization (HERO)
 Non-profit 501(c)3 founded in
1996
HERO Vision is to promote a
culture of health and performance
through employer leadership
HERO Mission is to promote a
healthy and high-performing
workforce through evidence-based
health management as a core
business imperative
ABOUT HERO ACTIVITIES
COMPANY OVERVIEW

4. 4
The Voice of the Population Health Industry
• Conducts research
• Advocates on behalf of a population health
improvement model for better health outcomes and
controlling health care costs
• Represents stakeholders along the continuum of care:
employers, providers, insurers, brokers, technology
developers, benefits consultants
• Common goal: improving care coordination, risk
stratification, quality and accountability through patient
and physician engagement and better use of technology

5. Project Objectives
• Clinical judgment and (versus) quality processes
• Create a complete and consistent set of EHM
measures and standards to facilitate process
improvement
• Measures and standards are necessary to take
advantage of the window of opportunity to
move the industry forward
• Measures and standards will help us complete
the transition from clinician-based programs to
data-driven, health improvement processes

6. Collaborating Organizations
ActiveHealth Management Johnson & Johnson
Aetna Kaiser Permanente
Alere Mayo Health Solutions
AllOne Health Mercer
American Specialty Health Midwest Business Group on Health
APS Healthcare National Business Group on Health
Boeing NCQA
Capital Blue Cross NQF
Care Continuum Alliance Nurtur
CMI Media Onlife Health
Ethicon Endo-Surgery OptumHealth
eVive Health Prudential
Geisinger RAND Corporation
Health 2 U / HCA Redbrick Health
Health Dialog Riedel & Associates Consultants
Health Improvement Solutions,
Inc. StayWell Health Management
HealthFitness Truven Health Analytics
HealthStat University of Alabama
HERO University of Michigan
Hooper Holmes URAC
Human Resources Institute WebMD
IHPM WellSteps

7. Project Structure
Organizational
Support
Health Impact Satisfaction Participation
Financial
Outcomes
Productivity &
Performance
VALUE ON INVESTMENT

8. DEFINING THE DOMAINS
 Value on Investment: Direct, indirect and tangential costs, financial outcomes
and defining a value framework
 Financial Outcomes: Health care cost (medical and pharmacy), absence, disability, workers
compensation
 Health Impact: Change in health status associated with preventable health conditions and
resulting from health promotion program participation
 Organizational Support: The degree to which an organization commits to the health and well-
being of its employees.
 Participation: Evaluate participation in EHM programs that can be associated with producing a
positive impact on health-related outcomes
 Productivity & Performance: Quantifies worker presence at work, both physically and mentally
 Satisfaction: Client satisfaction, participant satisfaction

9. The Work Product
For each of the seven domains:
• Definition of each domain
• Evaluation of existing measures and overarching
issues
• Recommended measures
Recommended
standards (where
enough evidence exists
to make a
recommendation)

10. Value on Investment
• Ultimately, all other metrics feed into VOI
• Each employer’s circumstances (size, health benefit
structure, program scope, cost, etc.) will dictate that
somewhat different elements and weighting will
contribute to program evaluation.
• Question: How to balance disparate measures, varying
degrees of certainty regarding outcomes, and specific
employer needs and values to arrive at a sensible
assessment of program value?
• The VOI workgroup has created a framework for
answering this question.

11. Organizational Support
Scope: The degree to which an organization commits
to the health and well-being of its employees.
Key Elements
•Company stated health values
•Health-related policies
•Supportive environment
•Organizational structure
•Leadership support
•Resources & strategies
•Employee involvement
•Rewards & recognition

12. Health Impact
Scope
• A minimum set of measures and metrics
• Intended to capture the majority of the
variance in the change in health status
• Associated with preventable health conditions
• Resulting from health promotion program
participation.
Key Elements
• Physical health
• Mental/emotional health
• Health behaviors

13. Participant & Client Satisfaction
Scope: Propose and define measures and metrics
of Participant and Client Satisfaction
Key Elements - Participant
•Overall satisfaction (including Loyalty)
•Effectiveness
•Scope
•Convenience
•Communications
•Member Experience
•Cost
•Benefits
Key Elements - Client
• Overall satisfaction (including
Loyalty)
• Effectiveness
• Value
• Scope
• Member Experience
• Account Management
• Reporting

14. Participation
Scope
• Recommend definitions and measures to evaluate
participation in EHM programs
• Participation is closely aligned with active vs. passive
involvement in an EHM program
Key Elements
Contacts are two-way interactions, whether they are:
• In-person
• By phone
• Via web-technology interface
• Via a combination of modalities

15. Financial Outcomes
Scope: Measures and guidance
for employers to evaluate the
healthcare claims cost impact of
their EHM program.
Key Elements
•Appropriateness of direct claims
•Measuring and reporting fiscal savings
•Guidance on working with analysts
•Strengths and weaknesses of common methods

16. Productivity & Performance
Scope: Quantify worker presence at work,
both physically and mentally.
Key Elements
•Worker presence/absence
•Worker output and performance while at work